We actually love this paper. We got a lot out of it. There's actually a lot more said that fakeclaimers always say is fake. Some key takeaways:
1. very high numbers of alters is very possible. The highest number in this study was over 4,500! 40% had 26-50 alters, 4% had 51-75, 12% had 76-100, 19% had 101-200, 8% had 201-300, and 20% had 300+
2. there's "ad hoc" forming of alters, as in they form frequently and often arbitrarily. "One patient was so apprehensive about her consultation with me that no alter would agree to attend. A new alter was formed for the occasion." Some even "developed a pattern of forming new alters in the face of trivial stressors and inconveniences, or whenever they felt cornered." And there was evidence of forming multiple at once, "almost two-thirds developed complex splitting patterns so that more than one alter emerged on each occasion of the formation of new alters."
3. innerworlds! "Over two-thirds had developed elaborate inner worlds, in which the personalities interacted among themselves". And "in some cases alters appear to have been created to do no more than to fill roles in these inner worlds."
4. yes, fictives, and factives! Some "formed alters based on the therapist." And in fact, "most MPD patients have alters based on identification, internalization, and introjection". And introject-heavy proof: "a small percentage have formed a massive number of alters in this manner as a defence against object loss."
5. there's the phenomenon of essentially cycling through alters, or as the study describes, "with each major life change some or all of the alters were created anew, and their predecessors might either remain active or subside, and become covert or latent."
6. even full alters (not fragments) can be relatively similar to each other: "this patient, with over 4,500 alters, had only 300 alters that were as poorly defined as the alters in Case 19 [(fragments)]. They were remarkably full when they appeared, although many were quite similar to one another. It was as if the same "basic issue" types of alters could be reduplicated readily, and regenerated again and again over the course of the patient's life."
7. the author rejects "splitting" terminology in most cases because "the mind, rather than dividing itself, rather multiplies itself, recopies itself selectively, or rearranges a finite number of elements in patterns of great potential variety." And also, "if one understands the process of alter formation as one of defence reduplication and/or reconfiguration rather than division, the problem of wondering how the mind becomes divided into such complexity ceases to be relevant."
We love this. This study really speaks to us. And it was published in 1988. Amazing.